Individual provider Active NPI

Tracy Fitzpatrick

  • Professional Counselor
  • Wilmington, DE
National Provider Identifier
1720649171
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC-0000510 Issued in DE
Practice address
507 Philadelphia Pike
Wilmington, DE 19809-2177
Phone
(302) 762-8989
Fax
(302) 762-8983
NPI assigned
Jun 26, 2019
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC-0000510 DE Primary

Addresses

Primary practice location

507 Philadelphia Pike
Wilmington, DE 19809-2177

Mailing address

507 Philadelphia Pike
Wilmington, DE 19809-2177
Phone (302) 762-8989

Other practice location 1

507 Philadelphia Pike
Wilmington, DE 19809-2154
Phone (302) 762-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117001764 DE Practitioner - Mental Health Counselor 0143672915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coras Wellness and Behavioral Health LLCGroup PAC ID 1456741248, 14 clinicians
American Treatment Network LLCGroup PAC ID 8820402993, 11 clinicians

Practice addresses (Care Compare)

1114 S Dupont Hwy
Dover, DE 19901-4401
Phone (833) 886-2277

1206 Forrest Ave
Dover, DE 19904-3311
Phone (877) 286-5115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atn Physicians & Associates LLC CurrentSince Jan 1, 2024 Accepting new patients
American Treatment Network LLC CurrentSince Jan 1, 2024 Accepting new patients
Child, Inc Past Accepting new patients

Locations

1206 Forrest Ave
Dover, DE 19904
Phone (877) 286-5115

1120 W Township Line Rd
Ste 200
Havertown, PA 19083
Phone (484) 451-8313

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1720649171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198092177",
            "telephone_number": "302-762-8989",
            "fax_number": "302-762-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198092177",
            "telephone_number": "302-762-8989",
            "fax_number": "302-762-8983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 Philadelphia Pike",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198092154",
            "country_code": "US",
            "telephone_number": "302-762-8989",
            "fax_number": "302-762-8983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DE",
            "license": "PC-0000510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.